Medication tracking

ABSTRACT

A system and method is described for printing a label with an RFID tag. The system includes an RFID reader that queries a first RFID tag coupled to a first medicinal container that includes a medication. In response, the system receives a first unique identifier and uses the first unique identifier to determine a status of the medication, associate the first medicinal container with a medical provider and print a second label that includes a second RFID tag for a second medicinal container.

The present application claims priority to U.S. Patent Application No.61/913,337, filed Dec. 8, 2013, entitled ENHANCED MEDICATION MANAGEMENTIN THE OPERATING ROOM ENVIRONMENT, U.S. Patent Application No.62/000,570, filed May 20, 2014, entitled ANESTHESIA LABEL CREATION ANDMIXTURE PREFERENCES SOLUTION, U.S. Patent Application No. 62/020,576,filed Jul. 3, 2014, entitled MULTI-DOSE INVENTORY SOLUTION, and U.S.Patent Application No. 62/062,845, filed Oct. 11, 2014, entitledANESTHESIA CHECK; AUTOMATING AND IMPROVING THE WORKFLOW OF ANESTHESIALABELING, ADMINISTRATION, AND INVENTORY RECONCILIATION, each of which isincorporated herein by reference in its entirety.

BACKGROUND

Pharmaceutical items (for example, drugs, diluents, medical and surgicalsupplies, gauze, scissors, needles, labels, baggies, bandages,packaging, vial, syringes, and/or other items that the pharmacy isresponsible for), such as medications (for example, drugs, diluents,etc., in solid or liquid form), that have left a pharmacy of a medicalcare facility are to be managed closely to conform to regulatoryguidelines regarding use and waste, to avoid misadministration anddiversion, and to ensure appropriate inventory management and patientbilling. In this context, medical care providers administer medicationsreceived from the pharmacy or removed from a crash cart or otherpharmaceutical item storage unit. In some cases, prior to, or as partof, administration, the medical care providers transfer one or moremedications from one medicinal container (for example, a vial, syringe,etc.) to another medicinal container and/or combine multiple medicationsinto one medicinal container. As part of the transfer, the medical careprovider prepares a handwritten label for the new medicinal container ornew combination of medications in order to identify and track itthroughout its lifecycle within the medical care facility. In addition,the medical care provider is responsible for returning unusedmedications (including any medications in the new medicinal container)from the original set of assigned pharmaceutical items, or reporting theadministration, use, or waste of the medications, to the pharmacy forinventory management, billing, and regulatory control.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1A is a block diagram illustrating an environment for trackingmedications at a medical care facility.

FIGS. 1B and 1C are diagrams illustrating an embodiment of a labelreading station coupled to a pharmaceutical item storage unit.

FIGS. 2A and 2B are diagrams illustrating embodiments of a drug label.

FIGS. 3A and 3B depict embodiments of a user interface for mixing and/ordiluting one or more medications.

FIG. 4 depicts an embodiment of a user interface for monitoringmedications that are in the care of a particular medical care provider.

FIGS. 5A, 5B, and 5C depict embodiments of the user interface formonitoring the administration of medications to a particular patient.

FIG. 6 depicts an embodiment of a user interface for reconciling/wastingmedications.

FIG. 7 is a flow diagram illustrating an embodiment for generating alabel during a transfer of a drug and generating a restockingnotification.

FIG. 8 is a flow diagram illustrating an embodiment for generating alabel as part of a transfer of a drug.

FIG. 9 is a flow diagram illustrating an embodiment for generating arestocking notification.

DETAILED DESCRIPTION

System and methods are described herein for querying or readingmachine-readable data from labels associated with medicinal containers,generating new labels with machine-readable data, and tracking theadministration, waste, and return of medications in a medical carefacility. Although various aspects of the disclosure will be describedwith regard to examples and embodiments, one skilled in the art willappreciate that the disclosed embodiments and examples should not beconstrued as limiting.

Parent/Child Medicinal Containers and Medications

In the present disclosure, reference is made to medicinal containers(which may also be referred to as medicinal packages), including parentand child medicinal containers, and medications, including parent andchild medications. Examples of medicinal containers include, but are notlimited to, vials, ampoules, IV bags, syringes, or other containersconfigured to store a medication, and the like.

A child medication can refer to a medication that results from anaction, such as a transfer of a medication or combination of two or moremedications. A parent medication can refer to the medication used in theaction, such as a medication prior to combination with another (parent)medication or transfer. In addition, a child medicinal container canrefer to a medicinal container that stores the child medication and/or amedicinal container into which medications are added and a parentmedicinal container can refer to a medicinal container that storesparent medications and/or a medicinal container from which themedications in the child medicinal container were sourced.

Although referred to as parent and child medications and medicinalcontainers, it will be understood that a parent medicinal container (orparent medication) in one context may be a child medicinal container (orchild medication) in another context. Similarly, a child medicinalcontainer (or child medication) in one context may be a parent medicinalcontainer (or parent medication) in another context. For example, ifFentanyl in a vial is transferred to a syringe, and then combined withsodium chloride in an IV bag, the Fentanyl in the syringe can bereferred to as a child medication as part of the transfer to the syringeand as a parent medication as part of the combination with the sodiumchloride in the IV bag. Similarly, the syringe can be referred to as achild medicinal container as part of the Fentanyl transfer to thesyringe and as a parent medicinal container as part of the combinationof the Fentanyl with the sodium chloride in the IV bag.

In some cases, a child medicinal container may be a previously unusedmedicinal container and/or have a single parent medicinal container.Similarly, a child medication may have a single parent medication. Forexample, if Propofol is removed from a vial and added to a syringe, thevial can be considered the parent medicinal container and the syringecan be considered the child medicinal container and/or the Propofol inthe vial can be considered the parent medication and the Propofol in thesyringe can be considered the child medication. In such cases, thesyringe may have been previously unused, used with the same patient, orsterilized prior to the addition of the Propofol.

In certain cases, the child medicinal container may have multiple parentmedicinal containers and may even be the same as one of the parentmedicinal containers. Similarly, a child medication may have multipleparent medications. For example, if Fentanyl from one vial and sodiumchloride from another vial are combined into a syringe, the vials can bereferred to as the parent medicinal containers and the syringe can bereferred to as the child medicinal container and/or the Fentanyl andsodium chloride in the vials can be referred to as the parentmedications and the combined Fentanyl and sodium chloride in the syringecan be referred to as the child medication.

In some scenarios, the child medicinal container can be the same as oneof the parent medicinal containers. For example, if Fentanyl is in asyringe and sodium chloride is added to the syringe from a vial, thevial can be referred to as a parent medicinal container and the syringecan be referred to as a parent medicinal container and the childmedicinal container. Similarly, the Fentanyl in the syringe prior to thecombination and the sodium chloride in the vial prior to the combinationcan be referred to as the parent medications and the combined Fentanyland sodium chloride in the syringe can be referred to as the childmedication.

It will be understood that the system can track child/parent medicinalcontainers and/or child/parent medications, as desired. Accordingly, theexamples used above and throughout the description should not beconstrued as limiting. Furthermore, it will be understood that thesystem can track any pharmaceutical item and is not limited to trackingmedicinal containers and/or medications.

System Overview

The system described herein can be used for the identification andlifecycle tracking of medicinal containers within the medical carefacility environment, and can enhance the identification and lifecycletracking of medications that have left the medical care facilitypharmacy. Child medications or medicinal containers created outside thepharmacy (for example, at a crash cart, in a patient room, or in theoperating room) can be tagged using RFID technology or a serializednumber, or barcode, so that the child medication or child medicinalcontainer as well as any parent medications or parent medicinalcontainers assigned to the medical provider can be available in thepharmacy's inventory for reconciliation, regulatory reporting, and asoverall inventory management. In some instances, users may be barredfrom creating labels for child medications or medicinal containers thatdo not follow rules defined by the hospital and regulatory agencies, orfor medications to which the user does not have permissions.

In addition, the system can allow users to indicate administration andnon-administration of medications and other pharmaceutical itemsprovided by the pharmacy or elsewhere, or items created by the provider.By enforcing rules regarding the combination of medications, such asdrugs and/or diluents, and creation of child medications or medicinalcontainers, and enhancing the existing reconciliation workflow ofproviders in the medical care facility, the system can be used to createreports for use by the pharmacy and hospital for patient billing,detection and elimination of medication diversion, detection andelimination of medication misadministration and misuse, and otherprocedural errors or inefficiencies.

In some embodiments, the system can rely on data specific to eachpharmaceutical inventory item (for example, medicinal containers, suchas vials, ampoules, IV bags, and syringes, gauze, medical supplies,etc.) originating in the pharmacy or created by the user within themedical care facility environment. This data can be captured by readingdata encoded on RFID tags present on each item or alternatively byscanning a serialized barcode or QR code, or other technology, etc. Thesystem can create RFID or serialized barcode tags for placement on childmedicinal containers, and can provide the user with the ability toindicate the administration of medication and/or the disposal ofmedication.

Although described above with reference to identification and lifecycletracking of pharmaceutical items in the medical care facilityenvironment, it will be understood that the system can also be used toenforce adherence to regulations regarding creation of child medicationsor medicinal containers as well as proper administration of medications,such as disallowing the use of expired medications and medications frommanufacturer lots and/or medical care facility lots that have beenrecalled, and providing warnings, such when a syringe has already beenused by another patient.

Pharmaceutical items, such as medicinal containers, are processed inseveral different stages before being distributed to locations insidethe hospital such as smaller satellite pharmacies, dispensing stations,and pre-prepared groups of medications in kits and trays. The systemdescribed herein can track the location and custody of pharmaceuticalitems throughout these locations, and into the patient administrationenvironment. Once inside the patient administration environment, thesystem can enforce rules regarding the creation, administration, andreconciliation of both new and preexisting pharmaceutical items.

In the patient administration environment, the system can use ahandheld, tablet, or desktop device used to interact with the user, anRFID reader (or barcode or QR code reader) to identify thepharmaceutical items, and a printer used to create RFID or serializedtags for pharmaceutical items created within the patient administrationenvironment.

The system can further include a graphical user interface, anapplication programming interface, a database containing pharmaceuticalitems, user information, data related to hospital-specific workflows andrules, log entries for pharmaceutical item history, custody, location,administration, and other data, and an application that sends data tothe printer for the creation of standards-compliant pharmaceuticallabels for items created in the operating room environment.

The system can further record the physical location of items within ahospital or medical center campus, and the possession of items byspecific users. The system can use both physical checkpoints such asRFID readers, and workflow checkpoints to record the location of apharmaceutical item. For example, an RFID tag with a specific uniqueidentifier can be coupled to a 10 mL vial of Fentanyl, which is a DEASchedule II controlled substance. The unique identifier can be used tostore data regarding the Fentanyl and/or the vial in the database usedby the system. As the vial (and Fentanyl) physically moves throughoutthe medical care facility, RFID readers throughout the medical carefacility can record the physical movement and note the location and timethat the RFID tag of that pharmaceutical item was read.

Medicinal Container Tracking

Before the vial (and medication) leaves a pharmacy, the system canfacilitate the custody assignment of that vial (and medication) to aspecific user and can record the user in possession of the item, in aspecific place, and at a specific time. Tracking the chain of custodycan continue in the patient administration environment, as themedication can be administered directly to the patient (either partiallyor in its entirety), can be discarded into a waste receptacle (eitherpartially or in its entirety), can be returned to the pharmacy (eitherpartially or in its entirety), or can be used to create a childmedication or child medicinal container in the operating room, orelsewhere (either partially or in its entirety).

The system can track these additional movements and transformations,including any other assignments of custody that might occur within thepatient administration context, such as assigning custody to anotherprovider to complete a work shift or patient case or procedure. Toassign custody to another provider the custodian provider can scan abadge or otherwise self-identify to the system. The provider can thenscan the medications (separately or collectively) that are to changecustody. The receiving provider can similarly self-identify to thesystem and indicate to the system that they are taking custody. Thesystem can verify the status of the medications (for example,expiration, amounts, etc., as described in greater detail below). Inaddition, the system can verify that the receiving provider has theappropriate privileges to receive the medications.

Additionally, the system can enforce the rules of the medical carefacility by requiring one or more approval actions for changes incustody as well as one or more approval actions for user indications ofadministration or waste actions. For example, the system can allow aprovider to indicate they have discarded a pharmaceutical item into awaste receptacle, and if the medical care facility rules dictate thataction must be verified by another user, the system can provide theinterface and logging mechanism for the witness to verify the action,either through manual interaction with a graphical user interface or bythe system reading user information which may come from an RFID-enabledbadge or some other authentication method.

The tracking mechanisms of the system can pertain to pharmaceuticalitems compounded elsewhere on-site or within the patient administrationenvironment. The system can provide a detailed history of pharmaceuticalitems used in a patient administration environment regardless of theirorigin, by capturing a snapshot of the package and its contents as itexists over time. The data capture can enable the system to provide aclear picture into the movement of medications through medicinalcontainers. In turn, the system can allow staff members to locate anypharmaceutical item that has been identified as problematic, such asexpired or recalled medication, regardless of whether it has beenassigned to a user or a physical location, administered to a patient,discarded into a waste receptacle, or used in the creation of a childmedication or child medicinal container.

For example, in the patient administration environment an anesthesiologyprovider may have custody of a vial of Vecuronium bromide powder and avial of normal saline. The provider can create a child medication orchild medicinal container that combines an amount of Vecuronium bromidepowder in milligrams with an amount of normal saline in milliliters. Thesystem can handle the combination of pharmaceutical items of differenttypes, and can produce a child medication or child medicinal containerof the appropriate type. In the example above, the system can determinethat the combination of a powder and a liquid creates an item that is amixture, combining two liquids results in another liquid, and combiningtwo mixtures results in another mixture.

Similarly, the system can determine the appropriate unit of measure fromthe combination of pharmaceutical items measured in different units. Inthe example above, a powder measured in milligrams combined with aliquid measured in milliliters results in a mixture measured inmilligrams over milliliters. Similarly, a liquid measured in milliliterscombined with another liquid measured in milliliters, results in a newliquid measured in milliliters, and so on.

New Label Creation

As part of the process of physically combining items, the provider canuse the system to create an RFID label (or barcode or QR code label) toplace on the child medicinal container, which the system can use totrack location, custody, and administration of the contents of the childmedicinal container (“Vecuronium bromide in Normal Saline”), or childmedication, alongside the two parent medications or parent medicinalcontainers (“Vecuronium bromide” and “Normal Saline”). The system canautomatically create a new expiration date for the child medicationand/or child medicinal container based on rules set by the medical carefacility, or otherwise, and automatically calculate the volume of thecontents within the child medicinal container, or child medication. Thesystem can also update the quantity of the parent medicinal containers,or parent medications, as wells the expiration of the parent medicationsor parent medicinal containers to reflect that a sterile barrier hasbeen pierced. The system can block a provider from creating childmedications or child medicinal containers from expired or recalledsources, and it may not allow the provider to create child medicationsor child medicinal containers outside of rules established by themedical care facility, which includes the number of different itemswithin one child medicinal container as well as specific medicinalcombinations. Once the label has been created and placed on the childmedicinal container, the system can associate the label with the childmedication or child medicinal container and assign custody to theprovider.

The provider can use the system in the same way to produce anotherdistinct child medication or child medicinal container of “Vecuroniumbromide in Normal Saline” from the same parent medications or parentmedicinal containers used to create the first child medication or childmedicinal container. In this case, the system can record both childrenof the parent medications or parent medicinal containers, and track thelocation, custody, and administration of all of the medications ormedicinal containers separately. The system allows for the creation andtracking of multiple generations of pharmaceutical items. For instance,if a provider takes the second generation “Vecuronium bromide in NormalSaline” item and combines it with a large bag of normal saline for usein an IV drip, the system can create another RFID label for thethird-generation medication or medicinal container and track itscustody, location, and administration accordingly. Should the medicalcare facility or pharmacy need to account for every milligram ofVecuronium bromide from a specific manufacturer's lot, the system canenable them to find not only unused vials on pharmacy shelves, butsyringes drawn up in the patient administration context, as well as bagsof solution containing the contents of syringes drawn up in the patientadministration context.

The system can also be configured to track amounts of medications movingbetween items. For example, a provider may want to fill three syringeswith a DEA Class 2 drug, such as Fentanyl, but may not indicate theactual amounts transferred from each vial, and may simply “administer” asyringe rather than record partial use. At some point, the providerreconciles how much Fentanyl was used, administered, and wasted. Thesystem can record all of the parent medications or medicinal containerswhere Fentanyl came from and can also record all of the childmedications or medicinal containers, such as destination syringes orbags, as well as the cases, rooms and waste bins where any of themedicinal containers may have been placed. Accordingly, the actualreconciliation of how much Fentanyl was used, wasted, and returned canbe reconciled at some later point in time without knowing the exactvolumes of drugs in each item along the way.

Reconciling Medications

The system can also provide an efficient mechanism for reconciling theadministration and waste of pharmaceutical items in a patientadministration context. Through the use of RFID or serialized labels onthe pharmaceutical items, the provider can scan these items in bulk andperform one action on all of the items scanned, or can scan itemsindividual and perform more granular actions. For example, at the end ofa medical case in the operating room, the provider may have ten emptysyringes to reconcile. If all of the syringes are empty and the providerintends to place them all in a waste receptacle, the system can scan thegroup of items. The system can identify all items scanned and allows theuser to indicate the amount used (e.g. “all”) and intention (e.g.“discard”), which is then applied to all of the scanned items. Thesystem can also record partial amounts used or wasted of singlemedicinal containers (e.g. “10 mL used and 15 mL wasted from a 25 mLpackage”). The system allows for medical care facilities to specify theintentions they would like to track as well as rules regarding itemadministration and reconciliation, which includes the units of measureused to record administration and waste and whether to record massversus volume of an item. In addition to the manual reconciliation ofadministration and waste of items, the system can interact with patientelectronic medical record stored in systems accessible within thepatient administration context. The system can send data regardingsyringe contents, as well as receive data regarding actual use from thepatient's electronic medical records.

Restocking

The system can use the data captured within the patient administrationenvironment not only for reports within this environment but also forreports used in the pharmacy and medical care facility overall. Usingthe data captured in the location and custody tracking features, thesystem can provide reports indicating drawers and cabinets in specificlocations to be restocked due to expired, empty, recalled, or otherwiseincorrect inventory. In addition, the system can cause a display todisplay the inventory of a particular drawer or cabinet. Furthermore, aspart of the restocking, the system can query the RFID or serializedlabels on the new items, update the database accordingly, and report thecorrect state of the pharmaceutical and supply items in a particularlocation and as verified by the user. The system can additionallyprovide detailed reports on pharmaceutical and supply items assigned toa user, to a room, or to a patient case, and the end result of each ofthose items, thus clearly showing where pharmaceutical items such ascontrolled medications have been misused or lost. Beyond the day-to-dayworkflow of tracking drugs, the data captured within the system can beused for pattern detection of different events or situations such asdiversion patterns, over and under administration of drugs by aprovider, over or under billing of patients, pharmaceutical and supplyorder optimization, warning and calculation of waste and the impact onthe water supply and other predictive measures.

Tracking Environment

FIG. 1A is a block diagram illustrating an environment 100 for trackingmedications at a medical care facility. In the illustrated embodiment,the environment 100 includes a label reading station 102 communicativelycoupled with an information processing system 108 and an electronicmedical records database 110. The label reading station 102 can becommunicatively coupled directly with the information processing system108 and/or the electronic medical records database 110, such as via awired or wireless connection, or can be communicatively coupled via anetwork 112. The network 112 can be a local area network or a wide areanetwork, such as the internet, etc.

The label reading station 102 can be located in any location of amedical care facility, such as on a particular floor, in a particularwing, in an operating room, patient room, or other patientadministration environment. In some embodiments, multiple label readingstations 102 can be located throughout a medical care facility, such asin different patient rooms, operating rooms, etc.

In the illustrated embodiment, the label reading station 102 includes alabel printer 104 and a label reader 106. In some embodiments, the labelprinter 104 and the label reader 106 can be implemented as an RFID labelprinter and an RFID label reader, respectively. In certain embodiments,the label printer 104 and the label reader 106 can be implemented usinga variety of technologies, such as a bar code reader and printer, QRcode reader and printer, etc.

When implemented using barcode or QR code technology, the label reader106 can be configured to capture an image of a barcode or QR code and/oremit a laser that can capture the barcode or QR code data. Whenimplemented using RFID technology, the label reader 106 can beconfigured to emit an electromagnetic wave, such as a radio wave, thatactivates one or more RFID tags in proximity to the label reader 106.The emission of the electromagnetic wave can also be referred to as aquery. In some embodiments, the RFID tags used in conjunction with thelabel reading station 102 can be passive or active RFID tags.

The electromagnetic wave emitted by the label reader 106 can cause theRFID tags to generate a response that includes data stored on the RFIDtag. Upon receiving the data from the RFID tag, the label readingstation 102 can communicate with the information processing system 108and/or the electronic medical records database 110 to process the data.

In some scenarios, as part of the processing, the label reading station102 can generate a label to be affixed to a medicinal container. Thelabel printer 104 can be used to print the new label. In someembodiments, the new label can include an RFID tag that has storedthereon a unique identifier. In certain embodiments additionalinformation can be stored on the RFID tag, such as medication name data,expiration data, provider data, patient data, etc. In some embodiments,the label printer 104 prints information regarding the medication ontothe RFID tag. Some non-limiting embodiments of labels that can beprinted by the label printer 104 are described in greater detail belowwith respect to FIGS. 2A and 2B. In certain embodiments, the labelprinter 104 can be configured to print the RFID tag or print onto alabel that already includes an RFID tag. Similarly, in some embodiments,the label printer 104 can be configured to print a bar code or QR codeand/or print onto a label that already includes a bar code or QR code.

Although the illustrated embodiment shows the label reading station 102as including a label printer 104 and a label reader 106, it will beunderstood that in some embodiments the label reading station 102 mayinclude fewer or more components. For example, in some scenarios, thelabel reading station 102 can omit the label printer 104. In suchembodiments, the label reading station 102 can be placed at or near alocation where a medication is being administered to a patient. In suchsituations, a medical care provider can place a label near the labelreading station 102, which can be read by the label reader 106. Thelabel reading station 102 can then transmit the information to theinformation processing system 108 for processing. Accordingly, theinformation processing system 108 can update the medical records of theparticular patient with data regarding the administration of themedication, determine whether a particular medication has been providedto a patient located at or near the label reading station 102, determinewhether the medicinal container has been used previously, etc. In someembodiments the label reading station 102 can be implemented as aportable or handheld device that can be used to quickly and easily readRFID tags.

Furthermore, although reference is made throughout the specification tothe label reading station 102 performing various analytical orprocessing functions, it will be understood that, in some embodiments,the information processing system 108 performs these functions, and thelabel reading station 102 is used to acquire data from one or morelabels, display data based on data and/or instructions received from theinformation processing system 108, and print a label based on dataand/or instructions received from the information processing system 108.In such embodiments, the label reading station 102 can receivenotifications of processing functions performed by the informationprocessing system 108, such as indications of the verification of amedication and/or indications regarding associations between anycombination of medications, medicinal containers, unique identifiers,medical providers and/or patients, etc. Accordingly, in someembodiments, the amount of processing performed by the label readingstation 102 can be reduced and/or minimized, and the label readingstation 102 can act as a conduit to the information processing system108. In this way, the hardware requirements and costs of the labelreading station 102 can be reduced in favor of a larger or more robustinformation processing system 108. In certain embodiments, the labelreading station 102 can include the information processing system 108and perform all of the functions described herein.

The information processing system 108 can include one or moremicroprocessors, a data storage device 114, a personal health datastorage device 116, and a network interface for communication over thenetwork 112. In some embodiments, the information processing system 108can be implemented as a server or workstation located at a remotefacility or at the same medical care facility. The data storage device114 can include information regarding medications and pharmaceuticalitems used in the environment 100, user that are allowed to use thelabel reading station 102, account information for individual medicalcare facilities, audit information, reports, logs, and various ruleswith regards to the medications, etc.

The rules can include information regarding which medications can beused with each other, preferences for different users, how to calculateexpiration dates for medications, substitute medications that can beused in place of other medications, drug policies, etc. Using theinformation received from the label reading station 102 and data in thedata storage device 114, the information processing system 108 canverify the status of the medications, calculate expiration dates for themedications, determine whether a medication has been recalled or isexpired, provide mixing or dilutions suggestions, associate medications,RFID tags, and/or unique identifiers with medical care providers and/orpatients, generate restocking notifications, create new database entriesfor new medications and/or new RFID tags, track drug administrationand/or reconciliation, generate reports regarding drug administration byvarious providers, reports regarding drug administration to differentpatients, etc.

The personal health data storage device 116 can include personal healthinformation of the patients at a medical care facility, similar to thatstored in the electronic medical records database 110. In someembodiments, the personal health data storage device 116 stores a subsetof the data from the electronic medical records database 110, such asgender, allergic reactions, and medications received, etc. In certainembodiments, the personal health data storage device 116 is a copy ofthe electronic medical records database 110. In some cases, the personalhealth data storage device 116 can include data from multiple electronicmedical records databases 110 from various medical care facilities.

Furthermore, as data in the personal health data storage device 116 ischanged by the information processing system 108, a similar change canbe made in the electronic medical records database 110. Similarly,changes to the electronic medical records database 110 can be updated inthe personal health data storage device 116. In this way, the personalhealth data storage device 116 and electronic medical records database110 can be synched.

In some cases, additional requirements are placed on databases thatstore patient identifying data. Accordingly, in some embodiments, thedata storage device 114 can be implemented separately from the personalhealth data storage device 116, as either a separate database and/or ona distinct data storage device. However, it will be understood that incertain embodiments, the data storage device 114 and personal healthdata storage device 116 can be implemented as part of the same databaseand/or on the same storage device.

When implemented separately, the data storage device 114 can include aunique identifier for each patient that does not include personal healthdata. For example the unique identifier can be a unique number or otheridentifier. When the data storage device 114 desires to access personalhealth data, it can use the unique identifier to communicate with thepersonal health data storage device 116. In this way, the personalhealth information can be separated from non-personal healthinformation.

Furthermore, in some embodiments, the information processing system 108can omit the personal health data storage device 116. For example, insome cases a particular medical care facility may prefer not to have acopy of personal health information stored outside the electronicmedical records database 110. In such embodiments, the informationprocessing system 108 can omit the personal health data storage device116.

The electronic medical records database 110 can include patient specificinformation, such as gender, age, medical history, medications taken,allergies, weight, medical procedures, vital signs, audit info, andwhatever other information a medical care provider desires. Theelectronic medical records from the electronic medical records database110 can be used in conjunction with the rules in the data storage device114 of the information processing system 108 to determine whichmedications can be provided to a patient and generate labels at thelabel reading station 102.

In certain embodiments, the label reading station 102, the informationprocessing system 108, and/or the electronic medical records database110 can implemented in a single device. In some embodiments, theinformation processing system 108 and/or the electronic medical recordsdatabase 110 can be remotely located from the label reading station 102.For example, the electronic medical records database 110 and theinformation processing system 108 can be located at a different sitefrom the medical care facility. In some embodiments, electronic medicalrecords database 110 and the information processing system 108 can beproximally located at the same medical care facility, such as in thesame room or floor of the medical care facility.

FIGS. 1B and 1C are diagrams illustrating an embodiment of a labelreading station 102 coupled to a pharmaceutical item storage unit 152,such as a crash cart. In the illustrated embodiment, the pharmaceuticalitem storage unit 152 includes drawers 154, shelves 156, and a tabletop158. The drawers 154 can be locked drawers that require a key code toopen. Within the drawers can be stored various medications, including,but not limited to drugs, diluents (for example, sterile water, sodiumchloride, etc.), other supplies, etc. The shelves 156 can include unusedmedicinal containers and other medical supplies, such as tubes, baggies,gauze, etc., as desired. The tabletop 158 can be used for preparing thechild medications and/or child medicinal containers. For example, themedications found in the drawers 154 can be combined or mixed togetheras part of the preparation for a new medication.

In the illustrated embodiment, the label reading station 102 includes adisplay 160, a label printer 104. In addition, the label reading station102 can include a label reader (not shown), microprocessor, a datastorage device, and a network interface. The microprocessor can beconfigured to execute instructions stored in the data storage device andto read and write data to and from the data storage device. The networkinterface can be used by the microprocessor to communicate with theelectronic medical records database 110 and/or the informationprocessing system 108, as described previously with respect to FIG. 1A.

The display 160 can be used to prompt a user for information and todisplay information regarding the medications, labels, patients,medicinal containers, etc. For example, the display 160 can be used todisplay a prompt for the user to tap a label to the display 160 or tomove a label in close proximity to the display 160 such that the labelreader 106 can read the label. In addition, the display 160 can be usedto display information as the label reading station 102 prepares andprints a label. For example, the display 160 can display informationregarding a medication that will be printed onto a new label.

The label reader 106 (not shown in FIGS. 1B and 1C) can be locatedbehind the display 160 or in some other location within the labelreading station 102, such that when a label touches or is placed inclose proximity (for example, twelve inches or less, or some otherdesired distance) to the label reading station 102, the label reader 106can read the contents of the label. Furthermore, in some embodiments,the label reader 106 can be configured to emit an electromagnetic fieldlarge enough to capture data from all RFID tags stored in thepharmaceutical item storage unit 152. In this way, the label reader 106can determine when a medicinal container associated with an RFID tag isremoved from the pharmaceutical item storage unit without having totouch the RFID tag, or place the RFID tag in close proximity, to thelabel reading station 102. Although described with respect to RFIDtechnology, it will be understood that the labels can be implementedusing any number or combination of technologies including, but notlimited to bar codes, QR codes, etc.

As described previously with respect to FIG. 1A, the label readingstation 102 can be used in conjunction with the information processingsystem 108 to verify the status of medications in the pharmaceuticalitem storage unit 152. For example, labels associated with or coupled tothe medicinal containers in the pharmaceutical item storage unit 152 canbe queried and read by the label reading station 102. Once read, thelabel reading station 102 can look up information regarding themedications, such as the expiration date, recall information, warnings,etc. The label reading station 102 can also be used to print labels formedicinal containers. The new labels may replace old labels on amedicinal container and/or can be placed on an unused or child medicinalcontainer. The labels printed by the label reading station 102 will bedescribed in greater detail below with reference to FIGS. 2A and 2B.

The label reading station 102 in conjunction with the informationprocessing system 108 can further be used to manage inventory of thepharmaceutical item storage unit 152. For example, when a medication isremoved from the pharmaceutical item storage unit 152 by a user andscanned by the label reading station 102, the information can be used todetermine whether the pharmaceutical item storage unit 152 includes athreshold number of the medication that was removed. For example, ifPropofol is removed from the pharmaceutical item storage unit 152 andthere is only one vial of Propofol left in the pharmaceutical itemstorage unit 152, the label reading station 102 can generate anotification indicating that the pharmaceutical item storage unit 152should be restocked with more Propofol.

In some embodiments, the label reading station 102 and/or informationprocessing system 108 can track the total number of each medicationfound within the pharmaceutical item storage unit 152 and from use thatinformation to determine whether a threshold has been satisfied. In someembodiments, the label reading station 102 and/or information processingsystem 108 can use a one out one in policy such that for each medicationremoved, the label reading station 102 and/or information processingsystem 108 can request a replacement medication.

In determining whether a threshold has been reached, the label readingstation 102 and/or information processing system 108 can use templates,as described in greater detail in U.S. patent application Ser. Nos.14/472,410, and 13/554,342, each of which is incorporated herein byreference in its entirety. The templates can be used to identifysubstitute medications that can be used when a particular medication isnot present. For example, the templates can indicate a generic versionof a branded drug and/or other drugs that can be used as a substitute.In some embodiments, the substitute drug can be the same drug but at adifferent concentration or a different amount. In certain embodiments,the substitute drug may not be chemically equivalent and/or have adifferent active ingredient, but is deemed medically suitable for aparticular use or as a substitute to the missing drug.

The label reading station 102 and/or information processing system 108can further be used to manage and track which medications are in auser's possession. For example, when a doctor scans a label formedication A, medication A can be associated with the doctor, indicatingthat the doctor is in possession of a particular medicinal containerstoring medication A. Accordingly, throughout the day, as the doctorremoves medications from pharmaceutical item storage units 152,administers medications to a patient, or wastes medications, the labelreading station 102 and/or information processing system 108 can be usedto track all of the medications in the doctor's possession. Thisinformation can be used by the pharmacy to reconcile all medicationsused by the doctor and ensure medications are not misplaced, lost, orabused.

The label reading station 102 and/or information processing system 108can further be used to handle and reconcile waste. For example, after adoctor has administered a medication to a patient, any remainingportions of the medication in a vial or syringe may need to bediscarded. Accordingly, the label reading station 102 and/or informationprocessing system 108 can provide prompts for the doctor to discard themedications, and in some embodiments, prompt a second doctor to act as awitness for the reconciliation or waste of the medication.

In the illustrated embodiments of FIGS. 1B and 1C, the label readingstation 102 is coupled to the pharmaceutical item storage unit 152.However, it will be understood that the label reading station 102 can belocated in any one or more locations within a medical care facility. Forexample, the label reading station 102 can be located in an operatingroom, in a patient room, or in a pharmacy. Furthermore, the labelreading station 102 can be used in conjunction with the informationprocessing system 108 to track the administration of medications to apatient, determine allergic reactions of the medication with aparticular patient, update an electronic medical record of a patient,calculate waste based on an amount of medication given to a patient,and/or determine whether a particular medication has been usedpreviously, such as on a different patient, or is expired or recalled.

As a non-limiting example, when a doctor enters a patient's room and/oran operating room in which medications will be administered to apatient, the label reading station 102 can scan or read the contents ofan RFID tag associated with a particular medication. In this situation,the medication can be associated with the patient that is in the patientroom or operating room. Using this information, the label readingstation 102 and/or information processing system 108 can determinewhether the patient may have any allergic reactions to the medication,update the patient's electronic medical record with informationregarding the administration of the medication, and/or calculate thewaste based on the amount of the medication used on the patient. Inaddition, the label reading station 102 and/or information processingsystem 108 can determine whether the medication or medicinal containerhas been used previously. In this manner, the label reading station 102and/or information processing system 108 can prevent multiple uses of amedicinal container, such as a syringe, on different patients.

In some embodiments, the label reading station 102, can omit the display160 and/or the label printer 104. Furthermore, the label reading station102 can be any form factor, including a smaller or more portableelectronic device, such as a phone, tablet, personal electronic device,etc. For example, a smaller or more portable form factor of the labelreading station 102 can be used in an operating room and/or a patient'sroom to conserve space.

Furthermore, in some embodiments, a smaller form factor of the labelreading station 102 can be used as a type of wand to inventory thecontents of the pharmaceutical item storage unit 152. Once the contentsof the pharmaceutical item storage unit 152 are inventoried, theinformation processing system 108 can generate a template for thepharmaceutical item storage unit 152 for restocking purposes and/orcompare the inventoried items with a template to determine whether anyitems are to be restocked.

Labels

FIGS. 2A and 2B are diagrams illustrating embodiments of a label 202that can be printed by the label printer 104. In the illustratedembodiments of FIGS. 2A and 2B, the label 202 includes an applicatorportion 204 (204A and/or 204B), an RFID portion 206, and abbreviateddata portions 208, 210. The applicator portion can stand lengthwiseacross a longitudinal portion of the RFID portion 206 (for example as isshown with portion 204A in FIG. 2A or applicator portion 204 in FIG.2B), or can extend height-wise along a latitudinal portion of the RFIDportion 206, as shown with applicator portion 204B.

Similarly, the abbreviated data portions 208, 210 can extend height-wisealong a latitudinal portion of the RFID portion 206, as is shown in FIG.2A, or lengthwise along a longitudinal portion of the RFID portion 206,as is shown in FIG. 2B. In addition, the abbreviated data portions 208,210 can share or be coupled with each other along a longitudinalportion, as is shown in FIG. 2A, or along a latitudinal portion, as isshown in FIG. 2B.

In the illustrated embodiment of FIG. 2A, text printed on the RFIDportion 206 is oriented at a 90° angled difference from the text printedonto the abbreviated data portions 208, 210. In the illustratedembodiment of FIG. 2B, the text printed on the RFID portion 206 can havethe same orientation as text printed onto the abbreviated data portions208, 210.

Although FIGS. 2A and 2B illustrate specific embodiments of the label202, it will be understood that the various portions can be coupledtogether in a variety of orientations as desired. Furthermore, textprinted on any one or more of the portions can be printed in the sameorientation or in different orientations, as desired. In addition,although in the illustrated embodiments, the applicator portion 204extends across an entire length or height of the label, it will beunderstood that it can extend along a more or less of the RFID portion206 as desired. For example, the applicator portion 204A can extendalong less than the entire length of the RFID portion or more than thelength of the RFID portion 206. Similarly the applicator portion 204Bcan extend along the less than the entire height of the RFID portion 206or more than the entire height of the RFID portion 206. In someembodiments, the abbreviated data portions 208, 210 can be detachablycoupled to the RFID portion 206 and/or to each other. In this way, theabbreviated data portions 208,210 can be removed from the rest of thelabel 202 and applied to different portions of a medicinal container inorder to provide a user the ability to read information regarding thecontents of the medicinal container from a variety of positions, angles,or orientations.

The applicator portion 204 can include an adhesive formed on one sideand can be transparent or translucent. In this way, the applicatorportion 204 can be applied to a medicinal container, such as a syringe,without obscuring the view of any information printed on the medicinalcontainer, such as units of measure. However, it will be understood thatthe applicator portion 204 can be opaque.

In embodiments where the applicator portion 204 extends lengthwiseacross a longitudinal portion of the RFID portion 206, the label 202 canbe applied to the medicinal container in such a way as to reduce theamount of the label that extends away from the medicinal container. Thiscan reduce the likelihood of the label 202 catching onto some otherobject.

In certain embodiments in which the applicator portion 204 (for example,applicator portion 204B) in which the applicator portion 204 extendsalong a latitudinal portion of the RFID portion 206, the label 202 canbe configured so as to minimize or reduce the amount of adhesive used incoupling the label 202 to the medicinal container.

In the illustrated embodiment, the RFID portion 206 includes an RFIDtag, a printable surface, and is opaque. However, it will be understoodthat the RFID portion 206 can use other machine-readable data, such as abar code or QR code, etc. In addition, it will be understood that insome embodiments, the RFID portion can be transparent or translucentand/or not include a printable surface. Furthermore, in someembodiments, the RFID portion 206 does not include an adhesive, and incertain embodiments, the RFID portion includes an adhesive.

The RFID portion 206 can include machine-readable data, as well ashuman-readable text. The machine-readable data can include a serializedidentifier or unique ID stored on an RFID tag, which distinguishes theRFID tag from other RFID tags that are registered with the informationprocessing system 108. In this way, the information processing system108 can store data that is unique to the label 202, and enables theinformation processing system 108 to distinguish the label and themedicinal container to which the label is attached from all othermedicinal containers, including medicinal containers that form part ofthe same lot as the medicinal container.

Using the unique identifier, the information processing system 108 canstore and look up data unique to the label 202. For example, the datacan include one or more lot numbers to which the medication or medicinalcontainer belongs, chain of custody data, expiration data, recall data,drug class data, concentration data, total medication amount data,preparation data, transfer data, etc. This data can be used by theinformation processing system 108 to verify the status of the medicationcontained within the medicinal container, produce warnings, provideinstructions and/or information, and print labels. In some embodiments,the RFID portion 206 can store some or all of the data on the RFID tagincluded within the RFID portion 206. In some embodiments, the RFID tagincluded within the RFID portion 206 includes only the uniqueidentifier, and the other data associated with unique identifier isstored at the label reading station 102 and/or the data storage device114 of the information processing system 108.

In addition to the RFID tag, the RFID portion 206 can include text, andother information regarding the medication and/or the medicinalcontainer to which the label 202 is affixed. For example, the RFIDportion 206 can include a color identifier identifying the drug class ofthe medication, a drug name, concentration of the drug, total amount ofthe drug, expiration data, user identifier, preparation data, and/or anyother information desired. In this way, a user can read the text on theRFID portion 206 to determine the contents of the medicinal container.As mentioned previously, although reference is made to an RFID tagforming part of the RFID portion 206, it will be understood that othermachine-readable identifiers can be used, such as, a bar code, QR code,etc. Such identifiers can include either a unique identifier orserialized identifier, or additional data as described previously.

The abbreviated data portions 208, 210 in the illustrated embodiment ofFIG. 2A are opaque and include some of the data printed on the RFIDportion 206. For example, the abbreviated data portions 208, 210 of FIG.2A include the drug name and the concentration, as well as a color codeidentifier indicating the class of the drug. However, it will beunderstood that the abbreviated data portions 208, 210 can betransparent and/or translucent and need not have an adhesive portion.Furthermore, as mentioned previously the abbreviated data portions 208,210 can be detachably coupled to the RFID portion 206, such as using aperforated line, a separate sheet, etc. such that the abbreviated dataportions 208, 210 can be removed separately from the RFID portion 206and affixed to different portions of the medicinal container, asdesired.

Furthermore although illustrated as having two abbreviated data portions208, 210, it will be understood that the label 202 can have fewer ormore abbreviated data portions as desired. For example in someembodiments, the label 202 does not include any abbreviated dataportions or only one abbreviated data portion. In certain embodiments,the label 202 can include three or more abbreviated data portionsarranged in any number of orientations, such as the orientation shown inFIGS. 2A or 2B, or any other orientation as desired.

With respect to FIG. 2B, specific lengths and heights of the label 202,the applicator portion 204, the RFID portion 206, and the abbreviateddata portions 208, 210 are provided. However, it will be understood thatthe label 202, the applicator portion 204, the RFID portion 206, and theabbreviated data portions 208, 210 can be configured using any dimensionas desired. Accordingly, the dimensions illustrated in FIG. 2B shouldnot be construed as limiting.

Mixing and Dilution

FIGS. 3A and 3B depict embodiments of a user interface 300 for mixingand/or diluting a medication. In some embodiments, the user interface300 can be presented on the display 160 of the label reading station 102after a label 202 has been read by the label reading station 102.

FIG. 3A depicts an embodiment in which one label 202 has been read andFIG. 3B depicts an embodiment of the user interface 300 in which twolabels 202 have been read by a label reading station 102. It will beunderstood that additional labels 202 can be read as desired and/ormedication information can be entered manually.

In the illustrated embodiments of FIGS. 3A and 3B, the user interfaceincludes user data 302, an inventory link 304, a medicinal containerpreparation link 306, and a patient data link 308, first medicationinformation 310, second medication information 330 (FIG. 3B), a totalvolume field 320, a mixture object 322 and other interface objects,including a preview object 324, a print object 326, and a clear allobject 328.

The various links 304, 306, 308 can be used to navigate to variousportions of the user interface 300. For example, the inventory data link304 can be used to navigate to a portion of the user interface 300displaying medications that are in the possession of a user, as well asadditional information regarding the use of those medications, such asthe embodiments of the user interface 300 illustrated in FIGS. 4 and 6.The medicinal container preparation link 306 can be used to navigate toportions of the user interface 300 for preparing labels 202 formedicinal containers, such as the embodiments illustrated in FIGS. 3Aand 3B. The labels 202 can be prepared for medicinal containers thatalready include a label 202 and/or can be prepared for medicinalcontainers that do not include a label 202. The patient data link 308can be used to navigate to portions of the user interface in which dataregarding individual patients associated with the user are displayed,such as the embodiments of the user interface 300 illustrated in FIGS.5A, 5B, and 5C.

The medication names 312, 332 can include a proper name for themedication, a generic name for the medication and/or other identifyingname for the medication. The class identifier 313 can indicate the classof the medication, such as a drug classification. In some embodiments,the class identifier can be a color coded drug class identifier, orother identifier to indicate the classification of the medication ordrug.

The mass field 316 can indicate the total mass of the medicinalcontainer associated with the label 202 that is scanned by the labelreading station 102. The final concentration field 318 can indicate thefinal concentration of the child medication or content of a childmedicinal container. The total volume field 320 can indicate the totalvolume of the child medication or content of the child medicinalcontainer.

The first medication volume field 317 can indicate the volume of theparent medication being removed or the volume being removed from theparent medicinal container. Similarly, the second medication volumefield 338 can indicate the volume of the parent medication being removedand/or the volume being removed from the second parent medicinalcontainer and being added to the child medicinal container to form thechild medication.

By interacting with the mixture object 322, the system can provide theuser with one or more suggestions of diluents that can be combined withthe medication 312, as illustrated on FIG. 3A. The suggested medicationscan be based on medical facility rules (for example, medications thatthe medical care facility has indicated as being permissibly combinedwith a particular medication), best practices, user preferences (forexample, medications that the user has indicated that they prefer to usewith a particular medication), and/or user history (for example,previous medications that the user has used in the past).

The additional interface objects 324, 326, 328 can be used to controlportions of the user interface 300 and/or navigate to different portionsof the user interface 300. For example, interacting with the previewobject 324 can provide the user with a preview of a label to be printedbased on the contents of the user interface 300, and interacting withthe print object 326 can cause the label reading station 102 to print alabel 202 based on the information displayed on the user interface 300.

With continued reference to FIGS. 3A and 3B, once the relevantinformation has been captured regarding the generation of a new label,the label reading station 102 can communicate the information to theinformation processing system 108. In response, the informationprocessing system 108 can generate a new database entry in the datastorage device 114 for the child medication or child medicinalcontainer. The new database entry can include information regarding thedrug name, class identification, concentration, origin information(including information regarding the parent medications or parentmedicinal containers), expiration, volume information, lot numberinformation regarding the parent medications or parent medicinalcontainers, and other information to track the child medication or childmedicinal container.

Once the new label 202 is printed, the unique identifier from the RFIDtag of the label 202 can be associated with the new database entry. Insome embodiments this association can take place during the printing ofthe label 202 and/or following the printing of the label 202. Forexample, a user can tap or place the newly generated label 202 on ornear the label reading station 102. The label reading station 102 canread the unique identifier from the label 202 and use that informationto associate the unique identifier with the data regarding the contentsof the new medicinal container.

In addition, as part of this process, the information processing system108 can update the medication data associated with the parentmedications or parent medicinal containers. For example, the informationprocessing system 108 can update an expiration date for the parentmedications or parent medicinal containers from a sealed expiration dateto a broken seal expiration date, a vial expiration date to a syringeexpiration date, and/or a refrigerated expiration date to anon-refrigerated expiration date, etc., as described in greater detailbelow.

In some embodiments, the information processing system 108 can reducequantity data associated with the parent medications or parent medicinalcontainers and increase quantity data associated with the childmedication or child medicinal container. For example, if the parentmedicinal container is a vial and included four mL of Fentanyl, two ofwhich were removed and placed into the child medicinal container to formthe child medication, the information processing system 108 candecrement the quantity data associated with the parent medication and/orparent medicinal container by two mL and increase the child medicationor contents of the child medicinal container by two mL.

The first medication information 310 can include, but is not limited to,a medication name 312, a class identifier 313, concentration data 314, amass field 316, a final concentration field 318, origin data 315indicating the origin of the medication (shown in FIG. 3B), and a firstmedication volume field 317 (shown in FIG. 3B).

The second medication information 330 can include similar information.In the illustrated embodiment of FIG. 3B, the second medicationinformation 330 includes a medication name 332, concentration data 334,origin data 336 indicating the origin of the second medication, and asecond medication volume field 338. It will be understood that themedication information for each medication can include less or moreinformation as desired.

The various fields illustrated in the user interface 300 can be fillablefields or auto populated. In some embodiments some of the fields autopopulate based on data collected in a fillable field. For example, thetotal volume field 320 can auto populate based on the contents of thefirst medication volume field 317 and the second medication volume field338. Similarly, the final concentration field 318 can also be autopopulated based on the information from the mass field 316, the firstmedication volume field 317, and/or the second medication volume field338.

The origin data 315, 336 can indicate the origin of the medications,respectively. For example, the origin data 315 can indicate that thefirst medication originated from a medicinal container such as a vialthat also includes a label 202 uniquely identifying the vial. The origindata 336 can indicate that the second medication originates from amedicinal container that does not include a label 202. For example, thesecond medication can originate from an IV bag or drip line that is nottracked and/or does not include a label 202.

Medical Care Provider Inventory

FIG. 4 depicts an embodiment of the user interface 300 for monitoringmedications that are in the custody or care of a particular medical careprovider. In the illustrated embodiment of FIG. 4, the particularmedical care provider is “Michael Jamison,” as indicated by the userdata 302. In the illustrated embodiment of FIG. 4, the user interfaceprovides data regarding the medications that are in the care of themedical care provider, the amount of each medication, and indicationsregarding a quantity of each medication that needs to be returned to thepharmacy or accounted for.

In the illustrated embodiment of FIG. 4, the user interface provides themedication name and concentration 402, a medication volume 404, and aquantity of medicinal containers of the particular medication 406. Asthe medical care provider uses, wastes, or returns the medicinalcontainers, the information processing system 108 can update theinventory data of the user. In this way, the information processingsystem 108 can maintain an accurate record of the medications in thecustody of the medical care providers in a particular medical carefacility.

Medication Administration

FIGS. 5A, 5B, and 5C depict embodiments of the user interface 300 formonitoring the administration of medications for a particular patient.In some embodiments, the user interface 300 of FIGS. 5A, 5B, and 5C canbe presented on the display 160 of the label reading station 102 once auser logs into a label reading station 102 located in a patientadministration environment, such as an operating room or patient room,and indicates that medications are to be provided to a particularpatient.

In some embodiments, the information processing system 108 canautomatically determine that medications are to be provided to aparticular patient based at least in part on the location of the labelreading station 102 and the electronic medical records of the particularpatient. For example, if the label reading station 102 is located inoperating room 1 and the medical records of Abigail Jones indicate thatshe is in operating room 1, when the medical care provider logs into oraccesses the label reading station 102, the information processingsystem 108 can automatically determine that a procedure is in progressfor Abigail Jones and that the medical care provider will beadministering medications to Abigail Jones.

As the label reading station 102 in the operating room 1 reads RFID tagsassociated with various medicinal containers, the information processingsystem 108 can associate the various medicinal containers with theAbigail Jones and with the medical care provider (if it has not alreadydone so as part of a label creation). As the RFID tags are scanned,information regarding them can be displayed on the user interface 300.Furthermore, the information processing system 108 can verify the statusof the medications, log the date and time of administration, determinewhether Abigail Jones may have any allergic reactions to themedications, etc. The label reading station 102 can display applicablewarnings based on the processing of the information processing system108. For example, the label reading station 102 can display or sound awarning indicating a possible allergic reaction to a medication, anadverse reaction between two medications, an expired medication, etc.

As the medications are administered, the information processing system108 can update the data storage device 114, personal health data storagedevice 116 and/or the electronic medical records database 110. Forexample, the information processing system 108 can indicate in thepersonal health data storage device 116 and/or the electronic medicalrecords database 110 that a particular medication has been administeredto the patient.

In addition, the information processing system 108 can update themedication data for the particular medication to indicate the quantitythat was administered. From that information, the information processingsystem 108 can determine the amount of the medication that is to bereturned or wasted. Furthermore, the information processing system 108can update any expiration dates associated with the medication. Forexample, the expiration date may be changed from a sealed expirationdate to a broken seal expiration date, as described in greater detailbelow.

In the illustrated embodiments of FIGS. 5A, 5B, and 5C, the userinterface 300 includes a current patient data 502, completed procedurepatient data 504, a medication delivery time icon 506, a medicationdetailed information icon 508, add/edit medication icons 510, 512, andinformation regarding medications used during the procedure, includingdrug classification 514, medication name/concentration data 516, time ofadministration 518.

The patient data 502 and completed procedure patient data 504 caninclude information uniquely identifying a patient, such as a patientname, date of birth, gender, and/or a patient identification number,etc. The patient data 502 and completed procedure patient data 504 cancorrespond to patients with whom the user or medical care provider isworking or has worked. As mentioned previously, the label readingstation 102 and/or information processing system 108 can communicatewith an electronic medical records database 110 to retrieve dataregarding the patients of a particular medical care facility. Using thedata from the electronic medical records database 110, the informationprocessing system 108 can associate the patients with a particularmedical care provider.

The medication delivery time icon 506 and medication detailedinformation icon 508 can be used to alter the information displayed onthe user interface 300. In the illustrated embodiment of FIG. 5A, themedication delivery time icon 506 is selected and in the illustratedembodiment of FIG. 5B, the medication detailed information icon 508 isselected.

The add/edit medication icons 510,512 can be used to add informationregarding additional medications that are used during the currentprocedure with the identified patient. In some embodiments, theinformation can be added by scanning an RFID tag associated with amedicinal container.

The medication name/concentration data 516 can be similar to the drugname/concentration data 402 described previously with respect to FIG. 4.The time of administration 518 can indicate the time at which aparticular medication is administered to the patient. The drugclassification 514 can indicate the classification of the medication ordrug that is administered to the patient, as described previously.

The user interface can include additional information and objects asdesired. For example, in the illustrated embodiment of FIGS. 5A, 5B, and5C, the user interface 300 includes information regarding the type ofprocedure being performed on the patient, the start time of theprocedure, and a finish procedure object to indicate when the procedurefor the patient is completed and/or when the medical care providerleaves the procedure.

As mentioned previously, FIG. 5B includes an illustrated embodiment ofthe user interface 300 when the medication detailed information icon 508is selected. Accordingly, in the illustrated embodiment of FIG. 5B, theuser interface 300 further includes initial amount data 520,administered amount data 522, wasted amount data 524, remainder amountdata 526, and to waste amount data 528 for each medication.

In the illustrated embodiment, it is shown that a vial containing fivemilligrams of Midazolam was associated with the patient. Of the fivemilligrams, three milligrams were administered to the patient.Accordingly, the to waste amount data 528 of the user interface 300indicates that two milligrams of Midazolam are to be wasted. Oncewasted, the user interface 300 can be updated to reflect the wastedamount 524 as 2 mg and the to be wasted amount 528 as zero.

Furthermore, in the illustrated embodiment of FIG. 5B, a vial containing200 micrograms of Fentanyl has been associated with the patient, AbigailJones. However, the illustrated embodiment indicates that 250 microgramsof Fentanyl were administered. In such an instance when the amountadministered exceeds the initial amount of the medicinal container, awarning icon 530 can be provided. In addition, a warning message orpopup window can be displayed requesting additional informationregarding the discrepancy between the initial amount of the medicationand the amount administered. Using the popup window or additional datafield, a user can provide information indicating an additional initialamount 520. For example, it may be that the medical care provider used asecond medicinal container and administered 50 micrograms of Fentanylfrom the second medicinal container without the label reading station102 scanning an RFID tag associated with the second medicinal container.Accordingly, the medical care provider can update the initial amount ofFentanyl from 200 micrograms to 400 micrograms by scanning the RFID tagassociated with the second medicinal container (or manually entering theinformation). Upon updating the information, the information processingsystem 108 can calculate that the amount of Fentanyl to be wasted is 150micrograms and the user interface 300 can be updated accordingly, asillustrated in FIG. 5C.

Medication Reconciliation

FIG. 6 depicts an embodiment of a user interface 300 forreconciling/wasting medications. In the illustrated embodiment of FIG.6, the user interface 300 includes medication summary data 602, to wastemedication quantity 604, and to return medication quantity 606. Themedication summary data 602 can include a list of medications that arein the possession of the medical care provider or user.

The to waste medication quantity 604 can include the number of medicinalcontainers that include medications that are to be wasted. In theillustrated embodiment of FIG. 6, there are four medicinal containersthat include medications that are to be wasted.

The to return medication quantity 606 can indicate the number ofmedicinal containers that are to be returned to the pharmacy. Thisquantity may indicate medicinal containers that were never used by themedical care provider or medicinal containers that include medicationsthat can be reused by the pharmacy.

In addition, the user interface 300 can include additional informationregarding the medications that are to be wasted. For example, the userinterface 300 can include medication data 608, initial quantity data610, to waste quantity data 612, and drug classification data 614. Asdescribed in greater detail above, the item data 608 can includemedication name and concentration, the initial quantity data 610 caninclude an initial quantity of a medication and a particular medicinalcontainer, the to waste quantity data 612 can indicate the total amountof the particular medication that is to be wasted, and a drugclassification data 614 can indicate a drug classification of theparticular medication.

For medications that are to be returned, the user interface 300 caninclude some or different information as the information that is usedfor the medication that is to be wasted. For example, the user interface300 can indicate item data 608, medicinal container volume data 616,quantity of medicinal containers to return data 618, and drugclassification data 614.

The medicinal container volume data 616 can include informationregarding the volume of the medication within a particular medicinalcontainer and the quantity of medicinal containers to return data 618can indicate the number of medicinal containers containing a particularmedication that are to be returned to the pharmacy.

In addition, the user interface 300 can include a to waste witness icon620. By interacting with the waste witness icon 620, the user interface300 can enable the user to waste the medications. The user interface cancontrol what the user is able to do in order to enforce one or morepolicies set by the medical care facility. For example, the userinterface can require another medical care provider to witness thewasting of the medications. In addition, the user interface can requirethe witness to sign and/or scan in order to ensure that the witness ispresent for the wasting.

Following the wasting and reconciliation of the medications, theinformation processing system 108 can generate a receipt indicating theinventory of the medications that were in the possession of the user, aswell as a detailed report regarding which medications were administeredto which patients, which medications were wasted (and their quantity),the identification of the witness, and which medications were returnedto the pharmacy, etc. In this regard, the information processing system108 can provide a complete audit trail and chain of custody of amedication throughout its use at a medical care facility.

Flow Diagrams

FIG. 7 is a flow diagram illustrating an embodiment of a routine 700 forgenerating a label during a transfer of a medication, and generating arestocking notification. In some embodiments, routine 700 can be usedwhen a medical care provider desires to transfer one or more medicationsfrom one or more parent medicinal containers to a child medicinalcontainer, or create a child medication from one or more parentmedications.

One skilled in the relevant art will appreciate that the elementsoutlined for routine 700 can be implemented by one or many computingdevices/components that are associated with the environment 100,including, but not limited to, the label reading station 102, theinformation processing system 108, and/or the electronic medical recordsdatabase 110, or any combination thereof. For simplicity, routine 700has been associated as being generally performed by the label readingstation 102, and thus the following illustrative embodiments should notbe construed as limiting.

At block 702, the label reading station 102 queries a first RFID tag ofa first label. To query the first RFID tag, the label reading station102 can emit an electromagnetic wave that activates the first RFID tagor causes the RFID tag to emit a response. In some embodiments, such aswhen an RFID tag is not used, the label reading station 102 can includea QR code reader or bar code reader that is able to query the firstlabel containing machine-readable data.

At block 704, the label reading station 102 receives a first uniqueidentifier from the first label. As mentioned previously, each RFID tagcan include a unique identifier that uniquely identifies that RFID tagfrom all other RFID tags in a particular pharmaceutical item storageunit, at the medical care facility and/or that are tracked by theinformation processing system 108. In this way each medicinal containerassociated with an RFID tag can be uniquely identified.

Furthermore the information processing system 108 can include a databaseentry for each unique identifier. The database entry for the uniqueidentifier can include information regarding the medicinal container,medication name, drug classification, concentration of the medicationwithin the medicinal container, total volume, lot numbers associatedwith the medication and/or the medicinal container, expiration data ofthe medication, recall information regarding the medication, nationaldrug code (NDC), user and facility audit information, multi-doseinformation, refrigerated information, and/or event history etc. In someembodiments, the RFID tag can store some or all of the data associatedwith the unique identifier.

At block 706, the label reading station 102 can verify the status of themedication using the data associated with the first unique identifier.Although reference is made to the label reading station 102 verifyingthe status, it will be understood that in some embodiments, the labelreading station 102 receives a status from the information processingsystem 108 based on an analysis conducted by the information processingsystem 108, and in certain embodiments, the label reading station 102analyzes the data to determine the status. In some embodiments, toverify the medication status, the label reading station 102 candetermine whether the medication is part of a recall and/or has expired.

To determine whether the medication is part of a recall, the labelreading station 102 can cross-reference the lot numbers associated withthe first unique identifier (including lot numbers associated with theunique identifiers of all parent medications or parent medicinalcontainers) with lot numbers that have been recalled. In someembodiments, to verify whether a medication has been recalled, theinformation processing system 108 can consider only those lot numbersthat were created at the same time as or prior to the creation of thedatabase entry corresponding to the first unique identifier. Forexample, in some instances, a child medication is created or amedication is added to a child medicinal container and then somethinghappens to the medication remaining in the parent medicinal container,or parent medication, such that the parent medication is to subject to arecall or is to be discarded. However, in some embodiments, the recallis only applied to the medication remaining in the parent medicinalcontainer and does not apply to the child medication that was already inthe child medicinal container.

To verify the expiration of the medication, the label reading station102 can determine whether the current date and time is past anexpiration date and time of the medication. As part of the expirationverification, the label reading station 102 can identify multipleexpirations and use the earliest expiration to determine whether themedication is expired. For example, some medicinal containers mayinclude multiple medications. Each medication may have one or moreexpirations, the combination of the medications may create a differentexpiration, and one or more rules may apply to the medications orcombination thereof.

For example, some medications have an expiration based on refrigerationand a different expiration when not refrigerated. Similarly, once a sealof a medicinal container is broken, the expiration for a medication,such as a multi-dose medication, may change. For example, while sealed,a medication may have a one year shelf life, but once the seal is brokenor punctured, the expiration may change to 60 days from the time theseal was broken or punctured. The broken seal expiration may varydepending on the medication.

In some cases, when a medication is moved to a syringe, the expirationof the medication in the syringe is different than the expiration of themedication in a vial. For example, a medical care facility may have arule that all syringes expire within 12 hours of being drawn. In certainembodiments, the location of where the syringe is drawn can affect theexpiration. For example, a medical care facility may have a rule thatsyringes drawn in a patient administration environment expire in 24hours or less, while syringes drawn in a clean room expire in 7 days.Furthermore, in some embodiments, combining two medications can resultin a different expiration. As such, in embodiments where multipleexpirations are provided, the label reading station 102 can compare thecurrent date and time with the earliest expiration to determine whetherthe medication is expired. In certain embodiments, only the earliestexpiration is provided in conjunction with the unique identifier, and isused to determine whether the medication is expired.

In some embodiments, as part of verifying the status of the medication,the label reading station 102 can determine whether the medical providerhas appropriate rights or permissions to handle the medication. Forexample, some medications can only be handled by certain personnel at amedical care facility. Accordingly, the label reading station 102 canquery whether the medical provider that is attempting to handle themedication has the appropriate permissions.

In some embodiments, if the medication cannot be verified, the labelreading station 102 can display a warning or disallow the use of themedication. For example, the label reading station 102 can display awarning that the medication is expired or recalled. In addition, whentwo medications are being combined and the information processing system108 can, as part of the verification, determine whether the combinationwould have any adverse reactions. If the information processing system108 determines that the combination of the two medications would causean adverse reaction, the label reading station 102 can display a warningor disallow the printing of a label for the combination, etc.

At block 708, the label reading station 102 generates a secondexpiration date for the medication. The label reading station 102 cangenerate the second expiration date in a variety of ways. For example insome embodiments the label reading station 102 can use the sameexpiration date as the parent medication or parent medicinal container.In certain embodiments, the label reading station 102 can generate thesecond expiration date based on one or more rules associated with theparent medication. For example, once Propofol has been removed from avial and placed into a syringe, its shelf life decreases to six hours.In such instances, the label reading station 102 can calculate thesecond expiration date based on the rules of the Propofol, or otherapplicable rules of the parent medication(s) or medical care facility,as described above.

In embodiments in which multiple parent medications are combined to formthe child medication, the label reading station 102 can generate thesecond expiration date by reviewing the expiration dates of all parentmedications that will be used to form the child medication, as well asany rules associated with the parent medications or medical carefacility. As mentioned previously, medications and combinations ofmedications can have various expirations. The label reading station 102can determine the second expiration date as the earliest expiration dateof all of the expiration dates of the parent medications, as well as theexpiration date based on any rules associated with the parentmedications.

At block 710, the label reading station 102 associates the first RFIDtag with a medical care provider. To associate the first RFID tag withthe medical care provider, the label reading station 102 can identifythe medical care provider that has logged into or scanned their badgeprior to scanning the first RFID tag. The label reading station 102 canthen associate the first unique identifier of the first RFID tag with aunique identifier of the medical care provider in the data storagedevice 114 of the information processing system 108. As part of theassociation, an entry can be added to the information associated withthe unique identifier of the RFID tag indicating that the medical careprovider has accessed, taken control of, is in possession of, and/or hasused the medicinal container associated with the first uniqueidentifier.

At block 712, the label reading station 102 can print medication data ona second label having a second RFID tag. The medication data can includethe name of the medication, the expiration of the medication, theconcentration of the medication, and/or the total volume of themedication in the second medicinal container. In addition to themedication data, the label reading station 102 can print informationregarding the transfer of the medication, including the date and time ofthe transfer, and the identification of the user that caused theprinting to occur.

In some embodiments, the label reading station 102 can print themedication and other data onto the labels described previously withrespect to FIGS. 2A and 2B. Furthermore, in some embodiments the secondRFID tag can include a second unique identifier that uniquely identifiesthe RFID tag from all other RFID tags included in the informationprocessing system 108.

At block 714 the label reading station 102 queries the second RFID tag.As described previously with respect to block 702, the label readingstation 102 can query the second RFID tag using electromagnetic waves.However, it will be understood that a variety of technologies can beused to query the machine-readable data contained on the second label.In some embodiments, the label reading station 102 can query the secondRFID tag during printing of the medication data on to the second label.In certain embodiments the label reading station 102 can query a secondRFID tag after printing the medication data onto the second label. Insuch embodiments, following the printing of the medication data on thesecond label, a user can tap or move the label onto or in closeproximity to, the label reading station 102.

At block 716, the label reading station 102 receives the second uniqueidentifier from the second RFID tag. As mentioned previously, thissecond unique identifier can be associated with, or used to generate, anew database entry for the data for the child medication or childmedicinal container. The database entry can include information similarto the database entry described previously.

At block 718, the label reading station 102 associates the secondmedicinal container with the medical care provider. For example, thelabel reading station 102 can associate the second unique identifierwith the medical care provider indicating that the medical care providercreated, is in possession of, or in some other way used the childmedication or child medicinal container associated with the secondlabel. In this way, the information processing system 108 can track thechain of custody of the child medication and/or child medicinalcontainer and provide audit information regarding its location and use.

At block 720, the label reading station 102 can associate the childmedication or child medicinal container (using the second uniqueidentifier) with a medical patient. For example, similar to the mannerin which the label reading station 102 associates the child medicationor child medicinal container with the medical care provider, the labelreading station 102 can associate the child medication or childmedicinal container with the medical patient. For example, the secondunique identifier can be associated with the medical patient indicatingthat the child medication is to be used for the medical patient.

At block 722, the label reading station 102 determines that thepharmaceutical item storage unit does not store a threshold quantity ofthe medication. In some embodiments, the label reading station 102 canstore a complete inventory of the pharmaceutical item storage unit, suchthat each time a medicinal container is removed from the pharmaceuticalitem storage unit, the label reading station 102 can decrement the totalnumber of medicinal containers containing the particular medication. Thelabel reading station 102 can then compare the updated quantity ofmedicinal containers including a particular medication with a thresholdquantity of medicinal containers containing the medication. Upondetermining that the quantity of medicinal containers containing themedication does not satisfy the threshold quantity, the label readingstation 102 can generate a restocking notification, as illustrated atblock 724.

In some embodiments, the label reading station 102 may not store or knowthe inventory of the medication stored in the pharmaceutical itemstorage unit. As such, the label reading station 102 can implement a oneout one in inventory policy such that each time a particular medicationis removed from the pharmaceutical item storage unit, the label readingstation 102 can generate a restocking notification to replace themedication that has been removed.

In some embodiments, the label reading station 102 can use one or moretemplates to determine whether or not the pharmaceutical item storageunit stores a threshold quantity of a medication. The templates canindicate one or more substitute medications and/or substitute quantitiesthat may be used in case a particular medication does not satisfy thethreshold quantity. For example, one or more rules may indicate thatAdvil may be used in place of Tylenol. Accordingly, if a medicinalcontainer including Advil is removed from the pharmaceutical itemstorage unit, and the total number of Advil in the pharmaceutical itemstorage unit does not satisfy the threshold quantity of Advil, the labelreading station 102 can determine whether or not the number of Tylenolin the pharmaceutical item storage unit satisfies the threshold quantityof Advil. Based upon a determination that the quantity of Tylenol in thepharmaceutical item storage unit satisfies the threshold quantity ofAdvil, the label reading station 102 can determine that thepharmaceutical item storage unit stores a threshold quantity of Advil.However, in embodiments in which the label reading station 102determines that the pharmaceutical item storage unit does not store athreshold quantity of Advil (or Tylenol), the label reading station 102can generate the restocking notification, as illustrated at block 724.The restocking notification can include an email notification, textmessage, voicemail, page, or other visual and/or audible indication,etc. to enable a user to identify the location of the pharmaceuticalitem storage unit and medication that is to be replaced.

It will be understood that fewer, more, or different blocks can be usedas part of routine 700. For example, the routine 700 can omit block 720such that the second medicinal container is not associated with aparticular medical patient. Such an association can be reserved for adifferent time, such as when the second label is read by a label readingstation 102 that is in close proximity to the patient (for example, whenthe label reading station 102 is located in an operating room or in thepatient's room).

Similarly, in some embodiments the routine 700 can omit blocks 714 and716. In certain embodiments, the label reading station 102 can determinethe second unique identifier of the second RFID tag as it is printingthe medication data onto the second label. For example, in someembodiments the label reading station 102 can include a printer that canprint RFID tags. In such embodiments, as the label reading station 102is printing the medication data onto the second label, it can also printthe RFID tag. Accordingly, it can determine and/or know the secondunique identifier as it is being printed and does not query the RFID tagto receive the second unique identifier.

In some embodiments, the routine 700 can be used when multiplemedications are being combined into a child medicinal container ormultiple parent medications are used to create a child medication. Insuch embodiments, the routine 700 can include additional blocks forquerying multiple RFID tags associated with the parent medications thatare to be combined and receiving the unique identifiers for each parentmedication. In such embodiments, the routine 700 can furthermore verifythe status of each parent medication, and generate a second expirationdate based on the expiration dates of all of the parent medications. Insuch embodiments, the routine 700 can print child medication data thatincludes information regarding all of the parent medications that havebeen used to form the child medication.

Furthermore, routine 700 can include one or more blocks for tracking theinventory of a medical care provider, tracking administration of amedication to a patient, displaying information regarding patientsassociated with a particular medical care provider, and/or trackingwaste, as described in greater detail above with reference to FIGS. 4,5A, 5B, and 5C, and 6. For example, as part of the administrationprocess, the label reading station 102 can receive a unique identifierassociated with a medication, verify the status of the medication,associate the medication with a particular patient, determine whetherthe particular patient is allergic to the medication or will have anyadverse effects when combined with other medications that the particularpatient has received, identify discrepancies between an initial amountof the medication in a medicinal container and the amount of themedication administered to the patient, calculate an amount of themedication to waste, and/or track the waste of the medication that wasnot administered to the patient.

FIG. 8 is a flow diagram illustrating an embodiment for generating alabel as part of a transfer of a drug. In some embodiments, routine 800can be used when a medical care provider desires to transfer one or moremedications from one or more parent medicinal containers to a childmedicinal container or desires to create a child medication from one ormore parent medications.

One skilled in the relevant art will appreciate that the elementsoutlined for routine 800 can be implemented by one or many computingdevices/components that are associated with the environment 100,including, but not limited to, the label reading station 102, theinformation processing system 108, and/or the electronic medical recordsdatabase 110, or any combination thereof. For simplicity, routine 800has been associated as being generally performed by the label readingstation 102, and thus the following illustrative embodiments should notbe construed as limiting.

At block 802, the label reading station 102 queries a first label. Thefirst label can include a first RFID tag, or other machine-readable tag,such as a barcode or QR code. To query the first label, the labelreading station 102 can emit an electromagnetic wave that activates anRFID tag of the first label or causes the RFID tag to emit a response,capture an image of a barcode or QR code, and/or use a laser scannerthat can read a barcode or QR code.

At block 804, the label reading station 102 receives a first uniqueidentifier from the first label. As mentioned previously, each label caninclude a unique identifier that uniquely identifies that label from allother labels that are tracked by the information processing system 108.In this way each medicinal container associated with the first label canbe uniquely identified. As mentioned previously, the informationprocessing system 108 can include a database entry for each uniqueidentifier.

At block 806, the label reading station 102 can verify the status of themedication using the data associated with the first unique identifier,as described in greater detail above with reference to block 706 of FIG.7.

At block 808, the label reading station 102 associates the first labelwith a medical care provider. To associate the first label with themedical care provider, the label reading station 102 can identify themedical care provider that has logged into or scanned their badge priorto querying the first label. The label reading station 102 can thenassociate the first unique identifier of the first label with a uniqueidentifier of the medical care provider in the data storage device 114of the information processing system 108. As part of the association, anentry can be added to the information associated with the first uniqueidentifier of the first label indicating that the medical care providerhas accessed, taken control of, is in possession of, and/or has used themedicinal container associated with the first unique identifier.

At block 810, the label reading station 102 can print medication data ona second label having a second unique identifier. In some embodiments,the second label can include an RFID tag that includes the second uniqueidentifier. In certain embodiments, the second label can include abarcode or QR code that includes the second unique identifier. The RFIDtag, barcode, and/or QR code can be form part of the label prior toprinting the medication data or can be printed onto the label with themedication data. In some embodiments, the label reading station 102 canembed some or all of the medication data into the RFID tag, barcode,and/or QR code.

The medication data can include the name of the medication, theexpiration of the medication, the concentration of the medication,and/or the total volume of the medication in the medicinal container. Inaddition to the medication data, the label reading station 102 can printinformation regarding the transfer of the medication, including the dateand time of the transfer, and the identification of the user that causedthe printing to occur. In some embodiments, the label reading station102 can print the medication data and other data onto the labelsdescribed previously with respect to FIGS. 2A and 2B.

At block 812, the label reading station 102 queries the second label. Asdescribed previously with respect to block 802, the label readingstation 102 can query the second label using electromagnetic waves, animage capture, and/or a laser scanner. In some embodiments, the labelreading station 102 can query the second label during the printing ofthe medication data on to the second label. In certain embodiments thelabel reading station 102 can query the second label after printing themedication data onto the second label. In such embodiments, followingthe printing of the medication data on the second label, a user can tapor move the label onto or in close proximity to the label readingstation 102, scan the label, or capture an image of the label using thelabel reading station 102.

At block 814, the label reading station 102 receives the second uniqueidentifier from the second label. As mentioned previously, this secondunique identifier can be associated with, or used to generate, a newdatabase entry for the data for the child medication or child medicinalcontainer. The database entry can include information similar to thedatabase entry described previously.

At block 816, the label reading station 102 can associate the childmedication and/or child medicinal container (using the second uniqueidentifier) with a medical patient. For example, similar to the mannerin which the label reading station 102 associates the child medicationand/or child medicinal container with the medical care provider, thelabel reading station 102 can associate the child medication and/orchild medicinal container with the medical patient. For example, thesecond unique identifier can be associated with the medical patientindicating that the contents of the child medicinal container are, orthe child medication is, to be used for the medical patient.

It will be understood that fewer, more, or different blocks can be usedas part of routine 800. For example, in some embodiments, the routine800 can include any one or any combination of the blocks described abovewith respect to routines 700 or 900. In certain embodiments, the routine800 can omit blocks 812 and 814. In some embodiments, the label readingstation 102 can determine the second unique identifier of the secondlabel as it is printing the medication data onto the second label. Forexample, in some embodiments the label reading station 102 can include aprinter that can print RFID tags, barcodes, and/or QR codes. In suchembodiments, as the label reading station 102 is printing the medicationdata onto the second label, it can also print the RFID tag, barcode,and/or QR code. Accordingly, it can determine and/or know the secondunique identifier as it is being printed and does not query the RFID tagto receive the second unique identifier.

As described above with respect to routine 700, it will be understoodthat routine 800 can be used when multiple parent medications are beingcombined to create a child medication and/or can include one or moreblocks for tracking the inventory of a medical care provider, trackingadministration of a medication to a patient, displaying informationregarding patients associated with a particular medical care provider,and/or tracking waste, as described in greater detail above withreference to FIGS. 4, 5A, 5B, and 5C, and 6.

FIG. 9 is a flow diagram illustrating an embodiment of a routine 900 forgenerating a restocking notification for a pharmaceutical item storageunit. In some embodiments, routine 900 can be used when a medical careprovider removes a medication from the pharmaceutical item storage unit.

One skilled in the relevant art will appreciate that the elementsoutlined for routine 900 can be implemented by one or many computingdevices/components that are associated with the environment 100,including, but not limited to, the label reading station 102, theinformation processing system 108, and/or the electronic medical recordsdatabase 110, or any combination thereof. For simplicity, routine 900has been associated as being generally performed by the label readingstation 102, and thus the following illustrative embodiments should notbe construed as limiting.

At block 902, the label reading station 102 queries a label. The labelcan include a RFID tag, or other machine-readable tag, such as a barcodeor QR code. To query the label, the label reading station 102 can emitan electromagnetic wave that activates an RFID tag of the label orcauses the RFID tag to emit a response, capture an image of a barcode orQR code, and/or use a laser scanner that can read a barcode or QR code.

At block 904, the label reading station 102 receives a unique identifierfrom the label. As mentioned previously, each label can include a uniqueidentifier that uniquely identifies that label from all other labelsthat are tracked by the information processing system 108. In this wayeach medicinal container associated with the label can be uniquelyidentified. As mentioned previously, the information processing system108 can include a database entry for each unique identifier.

At block 906, the label reading station 102 can verify the status of themedication using the data associated with the unique identifier, asdescribed in greater detail above with reference to block 706 of FIG. 7.

At block 908, the label reading station 102 associates the label with amedical care provider. To associate the label with the medical careprovider, the label reading station 102 can identify the medical careprovider that has logged into or scanned their badge prior to queryingthe label. The label reading station 102 can then associate the uniqueidentifier of the label with a unique identifier of the medical careprovider in the data storage device 114 of the information processingsystem 108. As part of the association, an entry can be added to theinformation associated with the unique identifier of the labelindicating that the medical care provider has accessed, taken controlof, is in possession of, and/or has used the medicinal containerassociated with the unique identifier.

At block 910, the label reading station 102 determines that thepharmaceutical item storage unit does not store a threshold quantity ofthe medication, and at block 912 the label reading station 102 generatesa restocking notification, as described in greater detail above withreference to blocks 722 and 724 of FIG. 7.

It will be understood that few or more or different blocks can be usedas part of routine 900. For example, in some embodiments, the routine900 can include any one or any combination of the blocks described abovewith respect to routines 700 and/or 800. Furthermore, as described abovewith respect to routines 700 and 800, it will be understood that routine900 can include one or more blocks for tracking the inventory of amedical care provider, tracking administration of a medication to apatient, displaying information regarding patients associated with aparticular medical care provider, and/or tracking waste, as described ingreater detail above with reference to FIGS. 4, 5A, 5B, and 5C, and 6.

Additional Embodiments

It will be understood that the methods and systems described herein canbe used in other applications. For example, the process of determiningthe second expiration date can be used in conjunction with the systemsand methods described in U.S. patent application Ser. Nos. 14/472,410,and 13/554,342, incorporated herein by reference. For example, when amedication having a multiple expiration dates or a variable expirationdate (for example, a refrigerated/non-refrigerated expiration date, asealed/broken seal expiration date, and/or a vial/syringe expirationdate, etc.), such as a multi-dose medication, is included in a pharmacykit, the information processing system 108 can verify the medicationbased on the earliest expiration date or active expiration date. Inaddition, when an event (for example, breaking the seal, etc.) occursthat alters the expiration date of the medication, the informationprocessing system 108 can update the medication data in the data storagedevice 114 or in the RFID tag with the new expiration date.

Terminology

Conditional language, such as, among others, “can,” “could,” “might,” or“may,” unless specifically stated otherwise, or otherwise understoodwithin the context as used, is generally intended to convey that certainembodiments include, while other embodiments do not include, certainfeatures, elements, and/or steps. Thus, such conditional language is notgenerally intended to imply that features, elements and/or steps are inany way required for one or more embodiments or that one or moreembodiments necessarily include logic for deciding, with or without userinput or prompting, whether these features, elements and/or steps areincluded or are to be performed in any particular embodiment.

Unless the context clearly requires otherwise, throughout thedescription and the claims, the words “comprise,” “comprising,” and thelike are to be construed in an inclusive sense, as opposed to anexclusive or exhaustive sense; that is to say, in the sense of“including, but not limited to.” As used herein, the terms “connected,”“coupled,” or any variant thereof means any connection or coupling,either direct or indirect, between two or more elements; the coupling orconnection between the elements can be physical, logical, or acombination thereof. Additionally, the words “herein,” “above,” “below,”and words of similar import, when used in this application, refer tothis application as a whole and not to any particular portions of thisapplication. Where the context permits, words in the above DetailedDescription using the singular or plural number may also include theplural or singular number respectively. The word “or” in reference to alist of two or more items, covers all of the following interpretationsof the word: any one of the items in the list, all of the items in thelist, and any combination of the items in the list. Likewise the term“and/or” in reference to a list of two or more items, covers all of thefollowing interpretations of the word: any one of the items in the list,all of the items in the list, and any combination of the items in thelist.

Depending on the embodiment, certain operations, acts, events, orfunctions of any of the algorithms described herein can be performed ina different sequence, can be added, merged, or left out altogether(e.g., not all are necessary for the practice of the algorithms).Moreover, in certain embodiments, operations, acts, functions, or eventscan be performed concurrently, e.g., through multi-threaded processing,interrupt processing, or multiple processors or processor cores or onother parallel architectures, rather than sequentially.

Systems and modules described herein may comprise software, firmware,hardware, or any combination(s) of software, firmware, or hardwaresuitable for the purposes described herein. Software and other modulesmay reside and execute on servers, workstations, personal computers,computerized tablets, PDAs, and other computing devices suitable for thepurposes described herein. Software and other modules may be accessiblevia local memory, via a network, via a browser, or via other meanssuitable for the purposes described herein. Data structures describedherein may comprise computer files, variables, programming arrays,programming structures, or any electronic information storage schemes ormethods, or any combinations thereof, suitable for the purposesdescribed herein. User interface elements described herein may compriseelements from graphical user interfaces, interactive voice response,command line interfaces, and other suitable interfaces.

Further, the processing of the various components of the illustratedsystems can be distributed across multiple machines, networks, and othercomputing resources. In addition, two or more components of a system canbe combined into fewer components. Various components of the illustratedsystems can be implemented in one or more virtual machines, rather thanin dedicated computer hardware systems and/or computing devices.Likewise, the data storage devices shown can represent physical and/orlogical data storage, including, for example, storage area networks orother distributed storage systems. Moreover, in some embodiments theconnections between the components shown represent possible paths ofdata flow, rather than actual connections between hardware. While someexamples of possible connections are shown, any of the subset of thecomponents shown can communicate with any other subset of components invarious implementations.

Embodiments are also described above with reference to flow chartillustrations and/or block diagrams of methods, apparatus (systems) andcomputer program products. Each block of the flow chart illustrationsand/or block diagrams, and combinations of blocks in the flow chartillustrations and/or block diagrams, may be implemented by computerprogram instructions. Such instructions may be provided to a processorof a general purpose computer, special purpose computer,specially-equipped computer (e.g., comprising a high-performancedatabase server, a graphics subsystem, etc.) or other programmable dataprocessing apparatus to produce a machine, such that the instructions,which execute via the processor(s) of the computer or other programmabledata processing apparatus, create means for implementing the actsspecified in the flow chart and/or block diagram block or blocks.

These computer program instructions may also be stored in anon-transitory computer-readable memory that can direct a computer orother programmable data processing apparatus to operate in a particularmanner, such that the instructions stored in the computer-readablememory produce an article of manufacture including instruction meanswhich implement the acts specified in the flow chart and/or blockdiagram block or blocks. The computer program instructions may also beloaded onto a computing device or other programmable data processingapparatus to cause a series of operations to be performed on thecomputing device or other programmable apparatus to produce a computerimplemented process such that the instructions which execute on thecomputer or other programmable apparatus provide steps for implementingthe acts specified in the flow chart and/or block diagram block orblocks.

Any patents and applications and other references noted above, includingany that may be listed in accompanying filing papers, are incorporatedherein by reference. Aspects of the invention can be modified, ifnecessary, to employ the systems, functions, and concepts of the variousreferences described above to provide yet further implementations of theinvention.

These and other changes can be made to the invention in light of theabove Detailed Description. While the above description describescertain examples of the invention, and describes the best modecontemplated, no matter how detailed the above appears in text, theinvention can be practiced in many ways. Details of the system may varyconsiderably in its specific implementation, while still beingencompassed by the invention disclosed herein. As noted above,particular terminology used when describing certain features or aspectsof the invention should not be taken to imply that the terminology isbeing redefined herein to be restricted to any specific characteristics,features, or aspects of the invention with which that terminology isassociated. In general, the terms used in the following claims shouldnot be construed to limit the invention to the specific examplesdisclosed in the specification, unless the above Detailed Descriptionsection explicitly defines such terms. Accordingly, the actual scope ofthe invention encompasses not only the disclosed examples, but also allequivalent ways of practicing or implementing the invention under theclaims.

To reduce the number of claims, certain aspects of the invention arepresented below in certain claim forms, but the applicant contemplatesthe various aspects of the invention in any number of claim forms. Anyclaims intended to be treated under 35 U.S.C. §112(f) will begin withthe words “means for”, but use of the term “for” in any other context isnot intended to invoke treatment under 35 U.S.C. §112(f). Accordingly,the applicant reserves the right to pursue additional claims afterfiling this application, in either this application or in a continuingapplication.

What is claimed is:
 1. A system comprising: an RFID reader coupled to apharmaceutical item storage unit and configured to query a first RFIDtag of a first label coupled to a first medicinal container including amedication and receive a first unique identifier from the first RFIDtag, wherein the first unique identifier uniquely identifies the firstmedicinal container from all other medicinal containers; a computingdevice coupled to the RFID reader and configured to: receive the firstunique identifier, query a remotely located database for medication dataof the medication using the first unique identifier, verify a recallstatus of the medication using the medication data, verify a firstexpiration of the medication using the medication data, generate asecond expiration of the medication, and associate the first medicinalcontainer with a medical provider; and a printer configured to: print atleast a portion of the medication data and the second expiration on asecond label for a second medicinal container, the second labelcomprising a second RFID tag, wherein the second label comprises atransparent portion comprising an adhesive, a first opaque portion thatincludes the second RFID tag and does not include an adhesive, a secondopaque portion comprising an adhesive and a third opaque portioncomprising an adhesive, wherein a length of the transparent portionextends along a length of the first opaque portion and the at least aportion of the medication data is printed onto the first opaque portion,and a name of the medication is printed on the second opaque portion andthe third opaque portion, and wherein the second opaque portion and thethird opaque portion are detachably coupled to the first opaque portion,wherein the RFID reader is further configured to query the second RFIDtag and receive a second unique identifier from the second RFID tag ofthe second label coupled to the second medicinal container, the secondmedicinal container comprising a portion of the medication from thefirst medicinal container, and wherein the computing device is furtherconfigured to: receive the second unique identifier, associate themedication data and the second expiration with the second uniqueidentifier, associate the second medicinal container with the medicalprovider, determine whether the pharmaceutical item storage unit storesa first threshold quantity of the medication in one or more medicinalcontainers, and based at least upon a determination that thepharmaceutical item storage unit does not store the first thresholdquantity of the medication, determine whether the pharmaceutical itemstorage unit stores a second threshold quantity of a substitutemedication in the one or more medicinal containers, and based at leastupon a determination that the pharmaceutical item storage unit does notstore the second threshold quantity of the substitute medication,generate a notification that the pharmaceutical item storage unit doesnot store the first threshold quantity of the medication.
 2. The systemof claim 1, wherein the computing device is further configured to causea display to display one or more medications associated with the medicalprovider.
 3. The system of claim 1, wherein the substitute medicationcomprises a medication with a different chemical makeup than themedication.
 4. A system comprising: an RFD reader coupled to apharmaceutical item storage unit and configured to query a first RFIDtag of a first label coupled to a first medicinal container including amedication, and receive a first unique identifier from the first RFIDtag, wherein the first unique identifier uniquely identifies the firstmedicinal container from other medicinal containers in thepharmaceutical item storage unit; a computing device coupled to the RFIDreader and configured to: receive the first unique identifier, verify astatus of the medication in the first medicinal container using thefirst unique identifier, and associate the first medicinal containerwith a medical provider; and a printer configured to print medicationdata on a second label for a second medicinal container comprising atleast a portion of the medication from the first medicinal container,the second label comprising a second RFID tag, wherein the RFID readeris further configured to query the second RFID tag and receive a secondunique identifier from the second RFID tag of the second label coupledto the second medicinal container, the second medicinal containercomprising at least a portion of the medication from the first medicinalcontainer, and wherein the computing device is further configured to:receive the second unique identifier, associate the medication data withthe second unique identifier, and associate the second medicinalcontainer with the medical provider.
 5. The system of claim 4, whereinto verify the status of the medication in the first medicinal container,the computing device is configured to: determine that the firstmedicinal container is not subject to a recall, determine that themedication in the first medicinal container is not expired, anddetermine that the medical provider has appropriate rights to use themedication in the first medicinal container.
 6. The system of claim 4,wherein the computing device is further configured to cause a display todisplay one or more suggested medications for combination with themedication in the first medicinal container.
 7. The system of claim 4,wherein the medication data comprises a medication name, concentration,and total amount of the medication in the second medicinal container. 8.The system of claim 4, wherein to associate the first medicinalcontainer with the medical provider, the computing device is configuredto associate the first unique identifier with the medical provider. 9.The system of claim 4, wherein to associate the second medicinalcontainer with the medical provider, the computing device is configuredto associate the second unique identifier with the medical provider. 10.The system of claim 4, wherein the second label comprises a transparentportion including an adhesive, an RFID portion that includes the secondRFID tag and does not include an adhesive, a first opaque portioncomprising an adhesive and a second opaque portion comprising anadhesive, wherein a length of the transparent portion extends along alength of the RFID portion and the at least a portion of the medicationdata is printed onto the RFID portion, and a name of the medication isprinted on the first opaque portion and the second opaque portion, andwherein the first opaque portion and the second opaque portion aredetachably coupled to the RFID portion.
 11. The system of claim 4,wherein the computing device is configured to generate a notificationthat the pharmaceutical item storage unit does not store a firstthreshold quantity of the medication based at least upon a determinationthat the pharmaceutical item storage unit does not store a firstthreshold quantity of the medication and a second threshold quantity ofa substitute medication.
 12. The system of claim 4, wherein the secondmedicinal container is the same as the first medicinal container. 13.The system of claim 4, wherein the medication is a first medication, theRFID reader is further configured to query a third RFID tag of a thirdlabel coupled to a third medicinal container including a secondmedication, and receive a third unique identifier from the third RFIDtag, wherein the third unique identifier uniquely identifies the thirdmedicinal container from the other medicinal containers in thepharmaceutical item storage unit, the computing device is furtherconfigured to receive the third unique identifier, and verify a statusof the second medication in the third medicinal container using thethird unique identifier, the second medicinal container furthercomprises at least a portion of the second medication from the thirdmedicinal container, and the medication data printed on the second labelincludes information regarding the second medication.
 14. The system ofclaim 13, wherein the computing device is further configured tocalculate an expiration date for content of the second medicinalcontainer based at least in part an expiration date of the firstmedication in the first medicinal container and an expiration date ofthe second medication in the third medicinal container.
 15. The systemof claim 14, wherein the computing device is further configured tocalculate an expiration date for the content of the second medicinalcontainer based at least in part one or more rules associated with thefirst medication and one or more rules associated with the secondmedication.
 16. A method for printing a label for a medicinal container,the method comprising: querying a first RFID tag of a first labelcoupled to a first medicinal container, the first medicinal containerincluding a medication; receiving a first unique identifier from thefirst RFID tag, wherein the first unique identifier uniquely identifiesthe first medicinal container from other medicinal containers in apharmaceutical item storage unit; receiving a verification of a statusof the medication in the first medicinal container, wherein theverification is based at least in part on data associated with the firstunique identifier; receiving an indication of an association of thefirst medicinal container with a medical provider; causing a printer toprint medication data on a second label for a second medicinal containercomprising at least a portion of the medication from the first medicinalcontainer, the second label comprising a second RFID tag; querying thesecond RFID tag; receiving a second unique identifier from the secondRFID tag of the second label coupled to the second medicinal container,the second medicinal container comprising at least a portion of themedication from the first medicinal container; receiving an indicationthat the medication data has been associated with the second uniqueidentifier; and receiving an indication that the second medicinalcontainer has been associated with the medical provider.
 17. The methodof claim 16, wherein the second label comprises a transparent portionincluding an adhesive, an RFID portion that includes the second RFID tagand does not include an adhesive, a first opaque portion comprising anadhesive and a second opaque portion comprising an adhesive, wherein alength of the transparent portion extends along a length of the RFIDportion and the at least a portion of the medication data is printedonto the RFID portion, and a name of the medication is printed on thefirst opaque portion and the second opaque portion, and wherein thefirst opaque portion and the second opaque portion are detachablycoupled to the RFID portion.
 18. The method of claim 16, furthercomprising receiving an indication of a notification that thepharmaceutical item storage unit does not store a first thresholdquantity of the medication based at least upon a determination that thepharmaceutical item storage unit does not store a first thresholdquantity of the medication and a second threshold quantity of asubstitute medication.
 19. The method of claim 16, wherein the secondmedicinal container is the same as the first medicinal container. 20.The method of claim 16, wherein the medication is a first medication,the method further comprising: querying a third RFID tag of a thirdlabel coupled to a third medicinal container including a secondmedication; receiving a third unique identifier from the third RFID tag,wherein the third unique identifier uniquely identifies the thirdmedicinal container from the other medicinal containers in thepharmaceutical item storage unit; and receiving an indication of averification of a status of the second medication, wherein theverification of the status of the second medication is based at least inpart on data associated with the third unique identifier, wherein thesecond medicinal container further comprises at least a portion of thesecond medication from the third medicinal container, and the medicationdata printed on the second label includes information regarding thesecond medication.